Liban

INTRODUCTION

Au Liban, vous trouverez une grande variété de soins. Les contraceptifs sont disponibles en pharmacie sans ordonnance. La contraception d'urgence ("pilule du lendemain") peut être aussi disponible sans ordonnance en pharmacie, bien que théoriquement vous ayez besoin d'une ordonnance. Notez qu'ellaOne, la contraception d'urgence la plus efficace sur le marché (en 2016), est disponible à Beyrouth. Vous pouvez effectuer des tests de dépistage anonymes d'IST à Beyrouth. Sachez que certains établissements ne font que des tests de dépistage du VIH, plutôt qu'un éventail d'IST. De plus, si vous faites une demande de permis de travail, on vous demandera d'effectuer un test de dépistage du VIH, et si les résultats sont positifs, vous serez expulsé. Vous pouvez avoir accès à des médicaments pour le VPH au Liban, mais il n'existe pas de programme national de vaccination. Il n'y a pas non plus de PrEP. En 2014, le congé maternité a été allongé de 7 semaines à 10 semaines. Enfin, l'avortement est illégal en toutes circonstances, sauf si la vie de la femme est en danger. Bien que la loi impose de sévères sanctions envers les personnes voulant ou procédant à un avortement, la réalité légale de la situation apparaît plus complexe. Il y a beaucoup d'avortements clandestins effectués à Beyrouth et, tant qu'aucun membre de la famille ne dépose plainte, le gouvernement semble fermer les yeux. Cependant, il faut être très prudente, et il est plutôt conseillé d'effectuer un avortement dans des pays où il est autorisé, comme la Turquie.

Contraception

Note : il existe de nombreux moyens de contraception, comme les DIU (dispositifs intra-utérins ou stérilets), les contraceptions orales, les patchs, les injections, les préservatifs, etc. Pour une liste complète, cliquez ici.

Lois et stigmatisation sociale

Au Liban, vous pouvez acheter des pilules contraceptives sans ordonnance. On estime à 58% le taux de femmes libanaises utilisant une forme de contraception. A Beyrouth, on estime que 26% des femmes utilisent des contraceptifs oraux, 20% utilisent un DIU, 24% utilisent les méthodes naturelles, 16% appliquent la méthode du retrait et 15% utilisent d'autres méthodes.

Bien que le Liban soit plutôt libéral comparé à beaucoup de ses voisins, l'éducation sexuelle et les relations sexuelles avant le mariage restent taboues. De plus, on rapporte souvent des cas de désinformation concernant la contraception, notamment la fausse croyance que la pilule contraceptive cause l'infertilité. Beaucoup de femmes gardent leurs distances avec l'éducation sexuelle et le planning familial, car elles ont peut-être des relations sexuelles avant le mariage, et se sentent de ce fait honteuses ou embarrassées.

Que prendre et où?

• Si vous êtes intéressée par la pilule contraceptive, vous pouvez en acheter en pharmacie. Les marques que vous pourrez trouver sont Belara, Diane-35, Femoven, Gracial, Lo-Femenal, Marvelon, Microgynon, Microval, Neogynon, Nordiol, Ovral, Microgynon-30, Nordette, Yasmin et Yaz.
• Vous trouverez l'anneau contraceptif (Nuvaring) dans les pharmacies de Beyrouth. Une pharmacie le vend pour 18 000 livres libanaises (Juillet 2017).
• Vous pouvez acheter des préservatifs en magasin et en ligne. Il existe une entreprise libanaise, appelée Yalla Condoms, qui vous permet d'acheter des préservatifs en ligne, si vous ne voulez pas en acheter en magasin. Sur leur site, Yalla explique: "Nous livrons vos préservatifs commandés ainsi que d'autres produits dans tout le pays. Le prix de livraison est de $5 pour toutes les commandes inférieures à $30, et gratuites au-delà. Nos commandes sont généralement livrées en 48h (2 jours ouvrés). Vous recevrez un email de confirmation dans les 24h suivants votre commande avec les détails de livraison. Nos produits vous protègent, nous protégeons votre vie privée. Nous ne vendrons jamais votre email, numéro de téléphone, ou quelle qu'autre information personnelle à aucun individu ou entité autre que notre entreprise. Les commandes sont envoyées et emballés discrètement."
• Si vous voulez un DIU, ils sont utilisés par 20% des femmes à Beyrouth, vous devrez par conséquent être en mesure d'en trouver facilement dans les hôpitaux ou cliniques pour femmes. Voir la rubrique "Examens gynécologiques" pour une liste de gynécologues recommandés à Beyrouth. Une des marques les plus courantes de DIU est Mirena.
• Si vous souhaitez un contraceptif injectable, vous pouvez trouver Depo-Provera ou Noristerat au Liban.

Contraception d'urgence (pilule du lendemain)

Notes importantes: La contraception d'urgence peut prévenir une grossesse jusqu'à 3 jours (72h) et parfois 5 jours (120h) après un rapport non protégé. Prenez le contraceptif d'urgence le plus tôt possible après le rapport non protégé. Si vous n'avez pas accès à la contraception d'urgence, les contraceptifs oraux peuvent être utilisés en remplacement, mais souvenez-vous de ce qui suit: 1- Seulement quelques contraceptifs peuvent être utilisés comme contraceptifs d'urgence, 2- Des contraceptifs différents nécessitent des dosages et des horaires différents pour pouvoir fonctionner en tant que contraceptifs d'urgence, 3- Vous devez uniquement utiliser les 21 premières pilules dans les packs de 28 pilules, 4- Ces contraceptifs seront probablement moins efficaces qu'une véritable contraception d'urgence. Pour des informations générales sur la contraception d'urgence, cliquez ici et ici. Les stérilets en cuivre peuvent aussi prévenir une grossesse jusqu'à 5 jours après un rapport non protégé.

Lois et stigmatisation sociale

Au Liban, vous pouvez apparemment vous procurer une contraception d'urgence (pilule du lendemain) sans prescription en pharmacie. Vous aurez malgré tout peut-être besoin d'une ordonnance (nous attendons toujours une confirmation à ce sujet), mais ça n'a pas l'air d'être imposé partout.

What to Get & Where to Get It

Note : La contraception d’urgence efficace le plus longtemps à ce jour est ellaOne. Elle peut être prise jusqu’à 5 jours (120 heures) après le rapport sexuel non protégé. Si ellaOne n’est pas disponible dans votre pays, le stérilet en cuivre peut également être utilisé pour éviter la grossesse, s’il est posé dans les 5 jours qui suivent le rapport non protégé. Si aucune de ces options n’est disponible et que le rapport non protégé remonte à plus de trois jours, vous pouvez tout de même prendre une contraception d’urgence, qui peut être efficace jusqu’à 5 jours. Notez cependant que les CU ne sont pas efficaces à 100 % et qu’elles doivent être prises le plus tôt possible.

Ci-dessous, vous trouverez des informations sur la contraception d'urgence. Si vous ne pouvez pas vous en procurer, vous pouvez utiliser la contraception orale habituelle en tant que contraception d'urgence, ce que nous vous expliquons plus bas. Informations fournies par Princeton EC Website.

"Produits dédiés / Antiprogestogènes Prendre 1 comprimé dans les 120 heures suivant le rapport non protégé:"

• ellaOne

"Produits dédiés / Progestérone uniquement Prendre 1 comprimé dans les 120 heures suivant le rapport non protégé:"

• NorLevo 1,5mg

Pilules contraceptives habituelles utilisées en tant que contraception d'urgence / progestérone uniquement: Prendre 50 comprimés dans les 120h après le rapport non protégé:

• Microval

Pilules contraceptives utilisées en tant que contraception d'urgence / Pilules combinées Note: dans les boîtes de 28 comprimés, il ne faudra utiliser que les 21 premiers comprimés. Prendre 2 comprimés dans les 120 heures suivant le rapport non protégé, puis prendre 2 comprimés 12 heures plus tard:

• Neogynon
• Nordiol
• Ovral

Prendre 4 comprimés dans les 120 heures suivant le rapport non protégé, puis prendre 4 comprimés 12 heures plus tard:

• Lo-Femenal
• Microgynon-30
• Nordette

Coûts

Une résidente explique qu'elle a payé 75,000 LBP pour ellaOne dans une pharmacie de Beyrouth. Cependant, il est probablement possible de trouver des pilules moins chères (autres qu'ellaOne), ou des pharmacies moins chères.

Infections et maladies sexuellement transmissibles (IST/MST)

Notes importantes - Renseignez-vous sur les traitements PrEP et PPE: Si vous pensez avoir été récemment exposé(e) au VIH (dans les 72h), demandez un traitement pour la PPE (prophylaxie post-exposition). C'est un traitement d'un mois qui sert à prévenir d'une infection au VIH après exposition au risque, et il est peut-être disponible dans la ville où vous vous trouvez. Prenez le traitement aussi tôt que possible. Pour plus d'informations, cliquez ici. Si vous risquez une exposition au VIH, demandez un traitement PrEP (prophylaxie pré-exposition). C'est une pilule à prendre quotidiennement qui peut prévenir d'une infection au VIH avant l'exposition au risque. Pour plus d'informations, cliquez ici.

Laws & Social Stigmas

If you are traveling to Lebanon as a tourist, there are no travel restrictions related to HIV or STI status (i.e. no medical certificate or tests required). However, if you are applying for a work permit in Lebanon, you are required to submit paperwork proving that you are HIV negative (and potentially negative for other STIs as well). If you are found to be HIV+, you will be deported and the recruitment agency will cover the repatriation costs.

While STI tests are available in Lebanon, they are reportedly not very common. There is a common misconception that people who have been abroad or participated in "hek-hek" (so-so) relations should get tested, but that not everyone should get tested. Furthermore, some men are reportedly too "macho" too get tested.

Regarding HPV, while Lebanese women are at risk, there seems to be limited HPV awareness. Furthermore, Lebanon has no national HPV vaccination program in place (as of 2016). Here's an article about suboptimal HPV awareness in Lebanon.

What to Get & Where to Get It

Testing Facilities

Please visit the city pages, like the Beirut page, for local recommendations.

Support

• Marsa Sexual Health Center: Free Psychological counseling for People Living With HIV, Free social counseling and follow-up, Psychosexual counseling and couples therapy, Reiki relaxation sessions. Phone/Fax: +961 1 737647; +961 70 713384 Beirut, Hamra, Clemenceau, next to Haigazian University, Mexico Street, Myrtom House Building, 2nd Floor. Email: info@marsa.me.
• Helem: "In Helem's health initiatives, we adopt a rights-based approach that recognizes the particularities of HIV/AIDS, sexually transmitted illnesses (STIs) and sexual health relative to LGBTs. We are partnered with local NGOs in long term projects that aim to raise awareness on HIV/AIDS and STIs among LGBTs and to place the sexual health concerns of sexual minorities on the agendas of policy-makers and health practitioners." Email: info@helem.net. Director's Email: director@helem.net, +961 1 568160 , +961 71 916146 (hotline).
• Lebanese AIDS Society: Address: Charles Malek Avenue, Beirut, Telephone: +961 1 217785, Fax: +961 1 218382, Email: jacques.mokhbat@gmail.com
• M-Coalition: Address: Saint Louis street, Yazbeck Center, 6th floor, P.O. BOX: 16 70 43, Achrafieh, Beirut - Lebanon, Telephone: +961 1 566 469 x108,, Email: info@m-coalition.org
• MENAHRA - Middle East & North Africa Harm Reduction Association: "MENAHRA aims to develop harm reduction in the Middle East and North Africa. MENAHRA comprises three sub-regional knowledge hubs responsible for capacity building, training, advocacy and documentation, and a network linking people working in this field." Address: PO Box 55391, Sin El Fil, Beirut, Telephone: +961 1 493211, Email: info@menahra.org
• National AIDS Control Programme: Address: Quarantina, behind Quarantina Hospital, Beirut, Telephone: +9611566100/1, Fax: +961 1 566102, Email: wholeb_nap@inco.com.lb, Web:
• Regional Arab Network Against AIDS (RANAA): "RANAA works to strengthen the role of the civil society in limiting the spread of HIV/AIDS in the MENA region, including those working with most at risk populations (MARPs), and ensuring the rights of PLHIV to live in dignity and have access to support, treatment & care..." Address: SIN EL FIL 55391 - North Metn, Beirut, Telephone: +961 1 482 428, Email: contact@ranaa.net
• Vivre Positif: "SIDC’s mission is to develop social solidarity by reinforcing healthy behaviour in Lebanon through community empowerment, prevention, harm reduction policies, advocacy, and psychosocial services.The work of SIDC primarily targets the youth and populations that are already affected and/or infected, by anticipating the problems that can mark them and tackling them as needed..." Address: Youssef Karam Street, Daou bldg, 1st floor, 55391 Sin el Fil, Telephone: +961 1 480714, Email: vivrepositif@sidc-lebanon.org

Medications & Vaccines

What to Get & Where to Get It

• If you're looking for a pharmacy in Beirut, you can usually spot one due to the green cross sign. They often say "pharmacy" in English as well.
• If you have a yeast infection, you can ask for a generic version of Fluconazole at the pharmacy.
• If you have a UTI, locals say that you can go the pharmacy and get medication without a prescription. You just explain what you think you have or your symptoms and the pharmacist will help you. Ideally, you should still visit a health care professional before self-diagnosing yourself with a UTI since antibiotics are required.
• It appears that both HPV vaccines (Gardasil and Cervarix) have been approved of in Lebanon. However, Lebanon has no national HPV vaccination program in place.
• There is no PrEP (pre-exposure prophylaxis) available in Lebanon.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

In Lebanon, you can primarily finds pads and pantyliners. While some tampons are sold, they are less common and can be expensive. As for menstrual cups, there seems to be no sellers of the major brands (like DivaCup, MoonCup, LadyCup, Lunette, etc.), so it's probably best to buy menstrual cups online.

Gynecological Exams

What to Get & Where to Get It

Please city pages for local recommendations, like the Beirut page.

Pregnancy

Laws & Social Stigmas

Lebanese women are entitled to 10 weeks of maternity leave. The previous law only allowed seven weeks but, in 2014, the law was changed to allow 10 weeks.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Lebanon, abortion is generally illegal, as stated in the Penal Code. It is only permitted when the woman's life is endangered by the pregnancy. This means that for all reasons, including to preserve physical health, to preserve mental health, rape or incest, fetal impairment, economic or social reasons, or availability on request, are not permitted.

Prosecution of abortion laws is under the jurisdiction of the religious courts. If a woman induces an abortion or consents to anyone performing an abortion her, that woman is subject to six months to three years of imprisonment. The person who performs the abortion (with the consent of the woman) is subject to one to three years of imprisonment. If the woman dies during the abortion, the person performing the abortion is subject to four to seven years in prison. If the woman does not consent to the abortion, the person who performed the abortion is subject to five years of forced labor -- and, if the woman died during the abortion (and did not consent), the person who performed the abortion is subject to at least 10 years of forced labor. If someone performed an abortion to "save the honor" of a descendent or relative to the second degree, or if a woman induced her own abortion to preserve her honor, there will generally be a reduced penalty. However, health care personnel typically receive more stringent penalties, and their licenses will be revoked while their businesses may be closed down.

According to Lebanese law, it is also explicitly illegal to disseminate any information that helps facilitate abortions, or to sell any objects that can help facilitate abortions. If someone does any of these things, they are subject to two months to two years of imprisonment.

Despite the strict laws, women do receive clandestine abortions in Lebanon. According to a 2002 report, "In theory, this law addresses the needs of the Lebanese community and everybody appears to be abiding by it. However, the real picture seems far from this. Experts in the field believe that Lebanese women are constantly breaking the law to accommodate their actual needs (LFPA, 2001). They also claim this violation is well known to policy makers. Yet, they are not willing to act accordingly. For many reasons, they are not ready to modify the law; at the same time, they are not enforcing its implementation but rather turning a blind eye to the perpetrators." Furthermore, The virtual absence of attempts to amend this law ever since, as well as the absence of research concerning its effect on the community, reflects that abortion does not seem to be a public issue of concern."

Generally, clinics charge $300-600 for clandestine abortions while hospitals charge around $3000. While some abortions are performed in generally hygienic facilities, many more seem to be performed in more run-down, "back-alley" or less hygienic conditions.

Some personal accounts of abortions in Lebanon:

• Bound by taboos, Lebanese women seek abortions
• Lebanon's Abortion Question

There is very little activism around legalization of abortion in Lebanon. There appears to be an attitude of "turning a blind eye" from all sides, whether governmental or social. However, if you are interested in reading a call for the legalization, you can check out the links below:

• Why Abortion Needs to be Legal in Lebanon

What to Get & Where to Get It

There are no official places to receive abortions in Lebanon. If someone is interested in obtaining a clandestine abortion, they should consult with a trusted physician or clinic. If someone is interested in potentially obtaining an abortion outside of Lebanon, legal abortions are performed in Turkey, Greece and Azerbaijan upon request. They are also available in Cyprus for certain circumstances (but, officially, not on request).

Advocacy & Counseling

What to Get & Where to Get It

• ABAAD Women & Girl's Safe Space - Safe Line: +961 81 78 81 78
• For domestic violence, call Kafa‘s Helpline: 03-018019
• For migrant domestic workers, call Kafa‘s Helpline: 76-090910
• For migrant domestic workers, call the Anti-Racism Movement (ARM)‘s Helpline: 76-350284
• For gay, lesbian, bisexual, and transgender support, call Helem‘s Helpline: 70-123687
• For child sexual abuse, call Himaya‘s Helpline: 03-414964
• For sexual and reproductive health services, call Marsa: 01-737647
• The A Project Sexuality Hotline: We are open from 5 PM to 11 PM at +961 71 210208. You can also email us at sexualityhotline@gmail.com. "Our hotline is accessible, confidential, and judgment-free. Who picks up the phone? We are volunteers trained in sexuality counseling, who promise you utmost respect and confidentiality."

List of Additional Resources

• ABAAD: "ABAAD is a non-profit, non-politically affiliated, non-religious civil association that aims to achieve gender equality as an essential condition to sustainable social and economic development in the MENA region. ABAAD seeks to promote women’s equality and participation through policy development, legal reform, gender mainstreaming, engaging men, eliminating discrimination, and advancing and empowering women to participate effectively and fully in their communities." Email: abaad@abaadmena.org
• The A Project: "The A project is about seeking agency, alternatives and autonomy in sexuality, sexual health, and gender. The project aims to address people living in Lebanon, young and not so young, through various programs. The project aims to work on sexuality, while looking at but not limiting the discussion to disease-prevention and violence, but also through an affirmative and sex-positive framework." Email: mashroualef@gmail.com, Hotline/ Whatsapp: +961 71 210 208, Skype: theaproject, Twitter: @MashrouAlef.
• Lebanon Family Planning Association: "LFPADE Mission is to strengthen the work in order to promote development in all its scopes and exerting special efforts to narrow the gap caused by the limited contribution of the Youth and Women in the development process especially in local communities, and to Cooperation with public administrations and municipalities in order to enhance efforts to keep up with visions emerging in the areas of population and development."
• KAFA: KAFA works to end all forms of gender-based violence
• Fe-Male: "Fe-Male, a non-profit organization founded in 2012 by a group of young women and human rights activists; a civil non sectarian Lebanese association that works under the umbrella of Human Rights Charter to ensure women’s rights as integral part of human rights; raising awareness, empowerment and changing laws are our objectives and our methods of work."
• Association Nadjeh: Works on women's rights issues in Palestinian refugee camps in Lebanon. Tel: (+961) 1 302079, (+961) 1 703357. Email: association@najdeh.org.lb.
• HELEM: "Helem leads a peaceful struggle for the liberation of the Lesbian, Gay, Bisexual and Transgender (LGBT) community in Lebanon from all sorts of legal, social and cultural discrimination." Email: info@helem.net. Director's email: director@helem.net. +961 1 568160 , +961 71 916146 (hotline) Facebook page:click here
• Proud Lebanon: "Proud Lebanon is non-religious, non-political, non-partisan civil rights society that aims to promote sustainable social & economic development in Lebanon and the region and will be working to achieve protection, empowerment and equality for marginalized groups through community service activities." Call +961 76 608 205. Email: info@proudlebanon.org.
• Lebanese LGBT Monitor: "The Lebanese LGBT Media Monitor is a project by Raynbow, a nonprofit organization that helps empower and support the LGBT movement in Lebanon."
• MOSAIC: "MOSAIC is a holistic program committed to improve the health and wellness of Marginalized groups in Lebanon and beyond. Through its national presence in Lebanon and its regional networks in the MENA region, MOSAIC strategic goal is to achieve the coexistence of people in friendly communities and national systems." Email: mosaic@mosaic-mena.org
• Himaya: An NGO in Lebanon that works on issues related to child abuse by holding sessions, reaching out to community, etc. "Our Prevention Program’s main goals are to raise awareness and detect possible cases of abuse while on the ground. Our teams are responsible of sessions they give to parents, professionals and children alike regardless of their religions, nationalities or disabilities. They must select a number of topics suited to their audience, create stimulating activities as well as guide and inform their listeners while remaining diligent enough to detect children who might require our attention. "
• The Anti-Racist Movement: The Anti-Racism Movement (ARM) was created by young activists in Lebanon in collaboration with migrant community leaders to challenge and fight racism in all its forms.
• Nasawiya: This group may no longer be active. "Nasawiya is a group of feminists (women and men) who are working together to challenge all forms of gender oppression in Lebanon and the Arab world."
• The Adventures of Salwa: This group may no longer be active. A campaign to fight sexual harassment.